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Africa has the highest maternal mortality rate in
the world |
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Experts on
reproductive health has painted a grim picture of
maternal and child health in the region and warned
that the situation could worsen in the next decade
if no immediate remedial actions were taken by
Africa's governments and development partners
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Many African countries have been hit by an exodus
of medical personnel to overseas destinations in
recent years. "Only 42% of births in the African
region are attended by skilled personnel," an
expert at the regional conference on maternal and
new-born health in Zimbabwe emphasised. Unsafe
abortions are also high among adolescents,
according to him. Experts, who are drawn from
various international organisations, are examining
the extent of the problem on the continent and
will suggest ways of reducing the death rates
among mothers and infants. African governments'
health budgets were also identified as inadequate
to deal with obstetric cases. "The percentage of
GDP (gross domestic product) devoted to health in
sub-Saharan Africa remains at between one percent
and 3,7% compared to the large percentage spent on
arms," they conveyed. "If nothing is done to
arrest the trend (of high and growing maternal and
child deaths), it is estimated that there will be
2.5 million maternal deaths, 2.5 million child
deaths and 49 million maternal disabilities in the
region over the next 10 years, Prof. Joseph
Kasonde noted. He states that more than half of
the 600,000 women who die every year from
pregnancy-related causes were in the African
region which constitutes only 12% of the world's
population and 17% of its births. Maternal
mortality ratio in Africa remains the highest in
the world with the average actually increasing
from 870 per 100,000 live births in 1990 to 1,000
per 100,000 live births in 2001. According to a
WHO-sponsored study made available at the regional
workshop on improving maternal and neonatal health
in Zimbabwe, neonatal morbidity and mortality
rates is currently estimated at 45 deaths per
1,000 live births and contribute about 50% of the
infant mortality rate in the region. The findings
of the study, presented by Dr Office Chidede, a
Consultant Neonatologist at the University of
Zimbabwe, also show that stillbirths and deaths
within the first seven days of life in the Region
was estimated at 76 per 1,000 live births. He also
indicated that 70% of deliveries take place in the
community where maternal and newborn births are
usually not recorded. Eight countries were covered
by the study conducted between February 2001 and
August 2002. Its goal was to develop or recommend
evidence-based strategic interventions and
establish sustainability in the
institutionalization and implementation of
identified remedial measures.
The study documents some of the causes of death as
provided by health providers and facility records.
These include: birth asphyxia (suffocation during
birth), 40%; prematurity and low birth weight,
25%; infections, 20%; congenital defects, 10%, and
acute surgical conditions, 3%. Other findings
relate to unavailability of basic supplies and
equipment, staff shortages and low morale, bad
roads and long distances between referral points,
continued use of traditional birth attendants (who
are still popular and highly regarded) and
preference of mothers to deliver in health
facilities, although these are still largely
perceived as not user-friendly. "Pregnancy in
adolescence presents a unique and frightening
picture," he highlighted, adding that 13% of all
maternal deaths occurred in adolescents, 14
million of whom gave birth annually worldwide.
Prof. Kasonde conveyed that in spite of the somber
picture, two major initiatives launched in the
past two decades had helped to stem the tide of
maternal and child deaths in Africa. These include
the Safe Motherhood Initiative launched in 1987
which drew attention to the multifaceted nature of
the problem and the need to invest in five key
critical areas: human rights, empowerment of
women, education, socio-economic development and
the improvement of health systems. The Making
Pregnancy Safer Initiative, launched in 2000,
focused on the health sector and its crucial role
in accelerating maternal maternity reduction. The
aim of the Initiative was to ensure that women and
their newborns have access to the care they need
through the strengthening of health systems and
appropriate community-level actions." He stated
that in spite of the harsh economic environment
prevailing in Africa, the application of
appropriate policies by governments would lead to
improvements in the outcome of pregnancies
irrespective of the economic status of countries.
According to him, it was now time for African
governments to focus on the availability of and
accessibility to emergency obstetric care because
emergencies constituted a major risk for maternal
mortality in Africa. Other essential
interventions, he said, were the reorganization of
health systems, the strengthening of midwifery
skills, and increasing the number of skilled birth
attendants. He further concluded his presentation
with a four-pronged call for action: action to
place maternal and newborn health high on the
agenda of governments and partners; to review
policies, guidelines and programmes; to allocate
and release resources and action to harness
resources from communities and partners.
In an presentation made at the regional conference
on maternal and new-born health the Zimbabwean
Secretary for Health and Child Welfare called for
a greater involvement of men in caring for their
spouses during pregnancy, basic education,
improved health systems and the use of skilled
birth attendants are key to reducing maternal and
newborn mortality in Africa. The Millennium
Development Goals call for a 75% reduction in
maternal mortality by in the African Region within
the next decade. She notes that other factors
crucial to attaining the goal included greater
empowerment of women, allocation of adequate human
and financial resources to the health sector, and
greater availability of user-friendly information
to improve individual, family and community
knowledge of danger signs during pregnancy and
labour. She emphasized that maternal deaths due to
pregnancy-related complications were preventable.
In another presentation to the meeting, the UNFPA
Maternal Health Adviser outlined some of the
reasons why African countries have failed to
reduce maternal mortality. These include: lack of
national commitment, financial support,
coordination and partnership; increasing poverty
and the low status of women; the adverse effects
of HIV/AIDS, tuberculosis and malaria, and the use
of inappropriate strategies to stem the growing
tide of maternal mortality. He stated that UNFPA's
vision and strategy for maternal mortality
reduction was based on three pillars: family
planning, skilled attendance at all births and the
availability of, and accessibility to, emergency
obstetric care. |
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Prematurity and low birth weight causes 25% of
infant deaths. Worldbank. |
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